{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:56:19Z","timestamp":1790736979502,"version":"4.1.0"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:00:00Z","timestamp":1790726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Theor Med Bioeth"],"DOI":"10.1007\/s11017-026-09770-5","type":"journal-article","created":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:37:44Z","timestamp":1790735864000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Likelihood ratios and the dependence of clinical evidence: should individual LRs be taken at face value?"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7824-4133","authenticated-orcid":false,"given":"Matheus Bento","family":"de Souza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Nunes","family":"de Alencar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,30]]},"reference":[{"key":"9770_CR1","doi-asserted-by":"publisher","DOI":"10.1017\/9781108500111","volume-title":"Evidence-based diagnosis: An introduction to clinical epidemiology","author":"TB Newman","year":"2020","unstructured":"Newman, T. B., and M. A. Kohn. 2020. Evidence-based diagnosis: An introduction to clinical epidemiology. 2nd ed. Cambridge: Cambridge University Press. https:\/\/doi.org\/10.1017\/9781108500111.","edition":"2nd ed"},{"key":"9770_CR2","volume-title":"The rational clinical examination: Evidence-based clinical diagnosis","year":"2009","unstructured":"Simel, D. L., D. Rennie, and S. A. Keitz, eds. 2009. The rational clinical examination: Evidence-based clinical diagnosis. New York: McGraw-Hill."},{"key":"9770_CR3","doi-asserted-by":"publisher","first-page":"647","DOI":"10.1046\/j.1525-1497.2002.10750.x","volume":"17","author":"S McGee","year":"2002","unstructured":"McGee, S. 2002. Simplifying likelihood ratios. Journal of General Internal Medicine 17:647\u2013650. https:\/\/doi.org\/10.1046\/j.1525-1497.2002.10750.x.","journal-title":"Journal of General Internal Medicine"},{"key":"9770_CR4","volume-title":"Clinical epidemiology: How to do clinical practice research","author":"RB Haynes","year":"2006","unstructured":"Haynes, R. B., D. L. Sackett, G. H. Guyatt, and P. Tugwell. 2006. Clinical epidemiology: How to do clinical practice research. 3rd ed. Philadelphia: Lippincott Williams & Wilkins.","edition":"3rd ed"},{"key":"9770_CR5","doi-asserted-by":"publisher","first-page":"e5903","DOI":"10.17267\/2675-021Xevidence.2024.e5903","volume":"6","author":"YB de Mello Gonzaga","year":"2024","unstructured":"de Mello Gonzaga, Y. B., A. D. Bacchi, and V. B. P. de Souza. 2024. When math legitimizes knowledge: a step by step approach to Bayes\u2019 rule in diagnostic reasoning. J Evid Based Healthc. 6:e5903. https:\/\/doi.org\/10.17267\/2675-021Xevidence.2024.e5903.","journal-title":"J Evid Based Healthc."},{"key":"9770_CR6","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1016\/j.jclinepi.2020.12.021","volume":"131","author":"MJL Bours","year":"2021","unstructured":"Bours, M. J. L. 2021. Bayes\u2019 rule in diagnosis. Journal of Clinical Epidemiology 131:158\u2013160. https:\/\/doi.org\/10.1016\/j.jclinepi.2020.12.021.","journal-title":"Journal of Clinical Epidemiology"},{"key":"9770_CR7","first-page":"563","volume-title":"Medicine update","author":"A Mohan","year":"2008","unstructured":"Mohan, A., K. Srihasam, and S. K. Sharma. 2008. Diagnostic reasoning: Approach to clinical diagnosis based on Bayes\u2019 theorem. In Medicine update, vol. Vol. 18, ed. S. K. Bichile, 563\u2013569. Mumbai: Association of Physicians of India."},{"issue":"9","key":"9770_CR8","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.45097","volume":"15","author":"A Ananda Rao","year":"2023","unstructured":"Ananda Rao, A., M. Awale, and S. Davis. 2023. Medical diagnosis reimagined as a process of Bayesian reasoning and elimination. Cureus 15 (9) : e45097. https:\/\/doi.org\/10.7759\/cureus.45097.","journal-title":"Cureus"},{"key":"9770_CR9","volume-title":"Harrison\u2019s principles of internal medicine","year":"2022","unstructured":"Loscalzo, J., A. S. Fauci, D. L. Kasper, S. L. Hauser, D. L. Longo, and J. L. Jameson, eds. 2022. Harrison\u2019s principles of internal medicine. 21st ed. New York: McGraw Hill.","edition":"21st ed"},{"key":"9770_CR10","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/0004-3702(78)90014-0","volume":"11","author":"P Szolovits","year":"1978","unstructured":"Szolovits, P., and S. G. Pauker. 1978. Categorical and probabilistic reasoning in medical diagnosis. Artificial Intelligence 11:115\u2013144.","journal-title":"Artificial Intelligence"},{"key":"9770_CR11","volume-title":"Evidence-based physical diagnosis","author":"S McGee","year":"2021","unstructured":"McGee, S. 2021. Evidence-based physical diagnosis. 5th ed. Elsevier.","edition":"5th ed"},{"issue":"1\u20132","key":"9770_CR12","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/0004-3702(93)90183-C","volume":"59","author":"P Szolovits","year":"1993","unstructured":"Szolovits, P., and S. G. Pauker. 1993. Categorical and probabilistic reasoning in medicine revisited. Artificial Intelligence 59 (1\u20132): 167\u2013180. https:\/\/doi.org\/10.1016\/0004-3702(93)90183-C.","journal-title":"Artificial Intelligence"},{"key":"9770_CR13","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/0004-3702(81)90011-4","volume":"16","author":"EP Pednault","year":"1981","unstructured":"Pednault, E. P., S. W. Zucker, and L. V. Muresan. 1981. On the independence assumption underlying subjective Bayesian updating. Artificial Intelligence 16:213\u2013222.","journal-title":"Artificial Intelligence"},{"issue":"1","key":"9770_CR14","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/0004-3702(85)90043-8","volume":"25","author":"C Glymour","year":"1985","unstructured":"Glymour, C. 1985. Independence assumptions and Bayesian updating. Artificial Intelligence 25 (1): 95\u201399. https:\/\/doi.org\/10.1016\/0004-3702(85)90043-8.","journal-title":"Artificial Intelligence"},{"key":"9770_CR15","first-page":"p.197","volume-title":"Machine intelligence and pattern recognition","author":"RW Johnson","year":"1986","unstructured":"Johnson, R. W. 1986. Independence and Bayesian updating methods. In Machine intelligence and pattern recognition, vol. Vol. 4, p.197-201. Amsterdam: Elsevier."},{"key":"9770_CR16","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1016\/0004-3702(92)90072-6","volume":"53","author":"FC Lam","year":"1992","unstructured":"Lam, F. C., and W. K. Yeap. 1992. Bayesian updating: On the interpretation of exhaustive and mutually exclusive assumptions. Artificial Intelligence 53:245\u2013254.","journal-title":"Artificial Intelligence"},{"key":"9770_CR17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjebm-2025-113664","author":"JN de Alencar","year":"2025","unstructured":"de Alencar, J. N., P. H. B. da Silva, and V. Borin. 2025. Romanticised Semiology. BMJ. Evidence-Based Medicine. https:\/\/doi.org\/10.1136\/bmjebm-2025-113664.","journal-title":"Evidence-Based Medicine"},{"key":"9770_CR18","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1056\/NEJMp068013","volume":"354","author":"S Jauhar","year":"2006","unstructured":"Jauhar, S. 2006. The demise of the physical exam. New England Journal of Medicine 354:548\u2013551. https:\/\/doi.org\/10.1056\/NEJMp068013.","journal-title":"New England Journal of Medicine"},{"key":"9770_CR19","doi-asserted-by":"publisher","DOI":"10.1201\/9780429428357","volume-title":"Introduction to probability","author":"JK Blitzstein","year":"2019","unstructured":"Blitzstein, J. K., and J. Hwang. 2019. Introduction to probability. 2nd ed. Boca Raton, FL: Chapman and Hall\/CRC.","edition":"2nd ed"},{"key":"9770_CR20","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1016\/S0140-6736(05)66422-7","volume":"365","author":"DA Grimes","year":"2005","unstructured":"Grimes, D. A., and K. F. Schulz. 2005. Refining clinical diagnosis with likelihood ratios. Lancet 365:1500\u20131505. https:\/\/doi.org\/10.1016\/S0140-6736(05)66422-7.","journal-title":"Lancet"},{"key":"9770_CR21","doi-asserted-by":"publisher","DOI":"10.1002\/9780470317082","volume-title":"Statistical methods in diagnostic medicine","author":"XH Zhou","year":"2002","unstructured":"Zhou, X. H., N. A. Obuchowski, and D. K. McClish. 2002. Statistical methods in diagnostic medicine. New York: Wiley-Interscience."},{"issue":"9","key":"9770_CR22","doi-asserted-by":"publisher","first-page":"981","DOI":"10.1002\/(SICI)1097-0258(19970515)16:9<981::AID-SIM510>3.0.CO;2-N","volume":"16","author":"H Brenner","year":"1997","unstructured":"Brenner, H., and O. Gefeller. 1997. Variation of sensitivity, specificity, likelihood ratios and predictive values with disease prevalence. Statistics in Medicine. 16 (9): 981\u2013991. https:\/\/doi.org\/10.1002\/(SICI)1097-0258(19970515)16:9%3c981::AID-SIM510%3e3.0.CO;2-N.","journal-title":"Statistics in Medicine."},{"key":"9770_CR23","volume-title":"How doctors think: Clinical judgment and the practice of medicine","author":"K Montgomery","year":"2006","unstructured":"Montgomery, K. 2006. How doctors think: Clinical judgment and the practice of medicine. Oxford: Oxford University Press."},{"key":"9770_CR24","volume-title":"Inference to the best explanation","author":"P Lipton","year":"2004","unstructured":"Lipton, P. 2004. Inference to the best explanation. 2nd ed. London: Routledge.","edition":"2nd ed"},{"key":"9770_CR25","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1017\/S0140525X00057046","volume":"12","author":"P Thagard","year":"1989","unstructured":"Thagard, P. 1989. Explanatory coherence. Behavioral and Brain Sciences 12:435\u2013467.","journal-title":"Behavioral and Brain Sciences"},{"key":"9770_CR26","doi-asserted-by":"publisher","DOI":"10.1201\/9781315116334","volume-title":"Diagnosis: Interpreting the shadows","author":"P Croskerry","year":"2017","unstructured":"Croskerry, P., K. Cosby, M. L. Graber, and H. Singh. 2017. Diagnosis: Interpreting the shadows. Boca Raton: CRC Press."},{"key":"9770_CR27","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1016\/B978-0-444-51787-6.50012-X","volume-title":"Philosophy of medicine","author":"K Sadegh-Zadeh","year":"2011","unstructured":"Sadegh-Zadeh, K. 2011. The logic of diagnosis. In Philosophy of medicine, vol. Vol. 16, ed. F. Gifford, 357\u2013424. Amsterdam: North Holland. https:\/\/doi.org\/10.1016\/B978-0-444-51787-6.50012-X."},{"key":"9770_CR28","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-41633-0","volume-title":"The fragility of philosophy of medicine: Essentialism, Wittgenstein and family resemblances","author":"L Karhausen","year":"2023","unstructured":"Karhausen, L. 2023. The fragility of philosophy of medicine: Essentialism, Wittgenstein and family resemblances. Cham: Springer."},{"key":"9770_CR29","doi-asserted-by":"publisher","DOI":"10.4324\/9781315735542","volume-title":"Causality, probability, and medicine","author":"D Gillies","year":"2018","unstructured":"Gillies, D. 2018. Causality, probability, and medicine. London: Routledge."},{"key":"9770_CR30","volume-title":"The direction of time","author":"H Reichenbach","year":"1991","unstructured":"Reichenbach, H. 1991. The direction of time. Berkeley: University of California Press."},{"key":"9770_CR31","volume-title":"A probabilistic theory of causality","author":"P Suppes","year":"1970","unstructured":"Suppes, P. 1970. A probabilistic theory of causality. Amsterdam: North-Holland."},{"key":"9770_CR32","doi-asserted-by":"publisher","first-page":"419","DOI":"10.2307\/2215337","volume":"13","author":"N Cartwright","year":"1979","unstructured":"Cartwright, N. 1979. Causal laws and effective strategies. Nous 13:419\u2013437.","journal-title":"Nous"},{"key":"9770_CR33","volume-title":"Nature\u2019s capacities and their measurement","author":"N Cartwright","year":"1989","unstructured":"Cartwright, N. 1989. Nature\u2019s capacities and their measurement. Oxford: Oxford University Press."},{"key":"9770_CR34","unstructured":"Hitchcock C. Probabilistic causation. In: The Stanford Encyclopedia of Philosophy, edited by Zalta EN, (Spring 2021 Edition)."},{"key":"9770_CR35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1086\/392759","volume":"67","author":"P Machamer","year":"2000","unstructured":"Machamer, P., L. Darden, and C. F. Craver. 2000. Thinking about mechanisms. Philosophy of Science 67:1\u201325.","journal-title":"Philosophy of Science"},{"key":"9770_CR36","volume-title":"Mental mechanisms: Philosophical perspectives on cognitive neuroscience","author":"W Bechtel","year":"2008","unstructured":"Bechtel, W. 2008. Mental mechanisms: Philosophical perspectives on cognitive neuroscience. New York: Routledge."},{"key":"9770_CR37","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h5527","volume":"351","author":"PM Bossuyt","year":"2015","unstructured":"Bossuyt, P. M., J. B. Reitsma, D. E. Bruns, C. A. Gatsonis, P. P. Glasziou, L. Irwig, et al. 2015. STARD 2015: An updated list of essential items for reporting diagnostic accuracy studies. BMJ 351 : h5527. https:\/\/doi.org\/10.1136\/bmj.h5527.","journal-title":"BMJ"},{"key":"9770_CR38","volume-title":"Statistical models and causal inference: A dialogue with the social sciences","author":"DA Freedman","year":"2010","unstructured":"Freedman, D. A. 2010. Statistical models and causal inference: A dialogue with the social sciences. Cambridge: Cambridge University Press."},{"key":"9770_CR39","volume-title":"Evidence-based medicine: How to practice and teach EBM","author":"SE Straus","year":"2019","unstructured":"Straus, S. E., P. Glasziou, W. S. Richardson, and R. B. Haynes. 2019. Evidence-based medicine: How to practice and teach EBM. 5th ed. Edinburgh: Elsevier.","edition":"5th ed"},{"issue":"11","key":"9770_CR40","doi-asserted-by":"publisher","first-page":"433","DOI":"10.1258\/jrsm.2010.100146","volume":"103","author":"J Howick","year":"2010","unstructured":"Howick, J., P. Glasziou, and J. K. Aronson. 2010. Evidence-based mechanistic reasoning. Journal of the Royal Society of Medicine 103 (11): 433\u2013441.","journal-title":"Journal of the Royal Society of Medicine"}],"container-title":["Theoretical Medicine and Bioethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11017-026-09770-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11017-026-09770-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11017-026-09770-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:37:53Z","timestamp":1790735873000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11017-026-09770-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,30]]},"references-count":40,"alternative-id":["9770"],"URL":"https:\/\/doi.org\/10.1007\/s11017-026-09770-5","relation":{},"ISSN":["1386-7415","1573-1200"],"issn-type":[{"value":"1386-7415","type":"print"},{"value":"1573-1200","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,30]]},"assertion":[{"value":"20 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 September 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 September 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}